Permit Int. Demo 112 7th St 2012 (2) CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00000GGO
Property Address . . . . . . 112 7TH ST Date 6/05/12
Application type description DEMOLITION (PARTIAL)
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 5000
----------- ----
Application desc
REMOVE EXTERIOR SIDING AND INTERIOR ONLY
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
PURCELL, EMILY BENHAM BOSCO BUILDING CONTRACTORS
654 OCEAN BLVD 2158 MAYPORT RD.
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 241-0320
Permit . . . . . . DEMOLITION PERMIT---------------------------------
Additional desc . .
Permit Fee . . . . 100 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 12/02/12
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Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 100 . 00 100 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 104 . 00 104 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
L'_ '�
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Q
,Job Address: Idol-
PermitNumber:
----------
1,e9alDeseription -'/-3)— /61 3 e Parcel
I'loor Area af SqTt. q. t
Valuation of Work S Proposed Work heated/cooled __� non-heated/cooled
C'hass of NVork (circle one): Ne%� Addition Alteration Repair Move, PEn�o— n pool/spa winclow'door
Use of existing/propose(i structure(�) (circle one): Commercial 4CQ�iR�_
Ifan existing structure, is a fire sprinkler system installed? (Circle one): Yes No
Florida ProductApproval #
For m ultiple prod ucts use 1j,Oduel approval torm
Describe in detail the tVpe of-work to be performed:
mon:
—Address:_('QS--/
c Statq):::7CZip 3��Phone !�Ivr
ail or Fax ,4 (Optional)
Contractor Information:
CompanyName: I yl
5 Qualifying AAgent:'
Address: 'j
city zi
001ce Plionc Job Site/Contact Number -State
State Certi f Icat ion/Registrat ion # p c,3_(0 V Fax#
Arciiiiect Name & Phone #
Engineer's Name & Phone#
Fee Simple Title I]older Naine and Address
l3onding Company Name and Address
Mortgage L,ender Name and Address
llwhcotioit is hereb.i maae to obtain a permit to tie)ille work and installations as indicated. certifi,Ilia,no work-or installation has collitnenceellwior to tilt!
Issil,Mcle of a i1crinit(oid that all work will be peribrmed to meet the standards of all laws regulating'consiruction ill thisjurisdiction. This1wititt becomes mw
told '()III I/It 01'k IS flol Commenced wilhin six(6i months, or�f constriietion or work is suspended or alYindonedfor a riod of'si.v(6)inonths(it am,unie aticr
w(WA Ls ('0111menced /understand that sel)arate permils must be secured ctricar work*, Plumbing, Signs, I'ells, Pli6ls, Furnaces, Boileis, Heaters.
TanAs andAir Conditioners,etc. .16r Ele r"
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
lhvr(�ht,L,ertill,Illot/have readonde.vantined this application ano'know the same to be true and correct.
�qw of work'ii Ill he f onildied with whether Specified herein or nor .The graliting of a permit does)lot presume to give atithorin,t VI / W ,, ancei the'
i)ro%Islons o I am othe� lt,deral. state. or local aw regulating construction or the Perfi7rmance of'construction- viola e or ca
SiunalUre of0m,'ner q )
.......-I— ---—--------- Signature of Contrac r
J_vz_�w 'Q
.. .......
lelf!�nt Name 7
11rint Name
S�,korn to and subscribed before ine Sworn to and subscribed before me
[.)a\ ot' '/ -
20 j�� th is
_Z5-Day of... 2 OKf
Not'11A Public
WILLIAM L.POPE Notary PuDlic
Notary Public,State of Florida WILLIAM L.POPE Revised 0 1,26.10
My Comm,Expires Oct.19,2m Notary Public,State of Florida
r,m_,.einn Kin W:190A; My Comm.Expires Oct.19,20%
41-
'-Id) A Settl0ment Statement(HUD-1) OMS Approval No.2502-0206
1114-V '
B.Type of Loan
FKA 2.11 RHS 3.E] COW UNINS, Is.ro.Number 7-Loan NwrJr- " -T&-M.M..
4.[� VA S.R COWWS, 12AD77 ct Ceas Number
C.NOW This fornn k furnished to give you a at
'10h,"Int Of actual deftment 0ows./Vnwmf
outsIlds I PaW40 real by"salbeanamt amt are shown,
-!!jdosWg""are shown hems for Infor 1�---- pld
0.Narms&Address or "OOOMI PWPOW6 and am not hdu�!d.ln ft tDWc
F Name,gAeldmasotaggar. - r--*
Emily Benham Purcell Shirley E.Ball I-Ming Trust, 17-N.-.i AdX;-or-L..,.
654 Ocean Blvd I
Atlantic Beach,Florida 32233 1
112 7th St Keith WatsOnTlle Services,Ina
Atlantic Beach,Florida 32233 , *j May 25,2012
,13A hWSLSOUthSUite2
Lot 8 Daniel&Hackett Replat of 91k 16 Atlantic J)!
Beach 0�ft)lls Beach,Florida 32250
q73-70D9 fax:(904)426-3227
a'' t:
Keith atson Tits Services,Ina
1326 Third St.South Suite 2
Jacksonville Beach,Florida 32250
Phone:(904)273-7009
Summary of Buyer's Transaction K. Summary of Seller's Transaction
1-01--Co-nt-rec-t Ules P�n-ca
401. nj jaSales-priog
-6LUINOM)P9
40Z Personal Pro
103, Settlement 013 08 to BU r line 14 297, 403,
Adluatiqwwrits foo Paid Is Seller in Ad hei:----
108, -CwTown-y strrwmts lior Item Id.0
107. 4 Ci /I Own MM
- I�U/128� 4
essments 4
easements
#5-012 .00 420. Gross
r0*5 ouit:�Due to-Seller --g56,-00-0
.00
26b.'AWo-un
-aO
ji-p 600. ROdu In Amount Due li�
26i Dipo's'Wor 20 501
_Earnest Money
p
2W-Principal Amount of Now Loan ��Lt
602. SaIllemont Charges to Seller(Line 1456------------14-.-92-g-
E;4tin .0()
.g Lonnie)taken subject to L
204;. Dail Interestcredit Itis5iij'Loan(i)taken sojW j6--
�Y-.----- . - 504.-:Ny6ffofj�jrstMOd9M' Loan-- '
466.-,-- 1-0 ' -017§jic�hd-M '-'
:A9-- faY2!0-fSGO....,jMRMNL0 Lun
ru rw Ortega
A 508L. Pur-ehasee Mo M,
djustments Ad u U -,"b
210, %,AV'6-1 lame C'-f Town axes
211. '..; 23.74 511, wres Jan 1,2 12 W.-M.y 24.-1
2D12 2012 .2MT4
-YI-2-Assessments 51
3.74 520'
. i A - _-16 1:49.74
300. Call ffift-ft-nt from I to Buyer:
OU1. Woes,AMOURdUmahm Buyer -6-5- 500.Usen t�Sfflar-t Ito I�ftom siellin
601. Gross Amount aue to SaW(line 420)
302.
_or Buyer(line UPI— 21,223.74 ouz. LOSS
_n�ou=ns A�rnqunt due I linq3M tj4
-§"LL --IT,_:
303. Cash From Buyer: $829,073.26 603. Cash To Seller $633,5611.26
The Public Reporting Burden for this collection of information is estimated at 35 minutes per response for collecting.reviewing,and reporting the
data.This 890ACY May not cobect this information,and you are not required to complete this form,unless it displays a currently valid OMS control
number.No corrildentiality,is assured;this disclosure is mandatory.This is designed to provide the parties to a RESPA covered traneaction with
information during the settlement process.
Ague editions are obsolete Page I of 4 HUD-1
May 22.2012 8:22 AM
SOMSM91 D811C May 25,2012 File Number 12AO77
'h- OLD REP IM77
!t riles
ChInVes That Cannot increase
LID Line No.
rat! !njtj6Fjjjjaroe - I- ' a = HUD
n �tjr2e Estimate
_i�--
00
edit or a #801 0.
U 0, 1802
0 O.OD
It L -
of t es -W-00
120
2 0_0 0.667
Chsrges'rhat In Total Cannot increase More Than 10% ----T—,.__�
G,6verrimirit Ria0terding Charges UD Una No, Good Fa T71 __ -HUD
Estimate,
6
-.0-0-
.11Ek�880,betwee G otal, 47.00
FEsndHUDCht!,rqja: _;f7_._00* __ __
Uy i 100.00%..
ChUgos That Can Change I
HUD Un9No.T Good Fiiiii
TRUS1 deposit fo HUD
it_.!,yoU_r-crC_W-�,�Unl -7.7" Eartifnate
at in I-NONE
0
OW
oan To .......#13D21
Your initial loan amount li
Merest rate Is 0
includes
�Yot4i 1AW 11`1060�711inount owed for principal,Interest,and
-rest,and
t7
X I Interest
Can your ir�dermmest Me a einsuranoo
any mortgage Insurance is X I Principal
'U. M to IX]No.. 1 5
I can nse to a maximum---if---------K__
.16ijiratchangewlillbe
and can change again every after
Every change date,your Interest rate can InGf—eaSoor decrease 3y
ths We of the loan,your Intere or
%or HIGHER than at rate Is guaranteed to never be LOWER then
ve %.
Ln:1t:jy:10u m:ako P"__,R6--i;i time,Loan You,hii I
rue? TX_JN�.'T__jVRTft can F—rim to ma0Wumoq—,—
and if--..th
Evvin 51-you make�Psyment5 on time,ran Yo&r_Ro_nthly ly a I month
_�2�4
amount*VNd for Principal,Interest and mortgage wad _
L"urance riso? can rise to s
The maximum it can ever rise to is
Im—um
y"nt penalty
Us I.
Does your loon he"a balloon payment? _!8PTYTFr no is S
�Rwo, 11 Yes,yinj 6"y 7, ant o us'.
years on tie
:t6tg�l�lO�&Yi�i�tinto*idlil�ludingesc;row'acc�u�j I X I You do not—haw'a monthly escrow paymorifi
payments for Items,such as li-rip"
I I You have an actilklonal monthly escrow payment of$
taxes and homeowner's insurance.YOU must pay these Items directly yourselt
results in a total initial monthly arriourit owed of 5 —that
principal,Interest,any mortgage insurance and —This Includes
any Rome checked below.
I Property taxes
I Flood insurance
Note'lCy-ou-have any qu 0-itions about—theSeWftement charges and Loan I wmr ustao on tha fortm,please contact j&4r_W—nckw. _1._
Page 3 of 4 HUD-1
May 22,ZD1 2 8:22 AM
Settlement Date:May 25,2012 File Number.12AO77
BuY*r$ OLD REP 12AO7,7
Emily Benham Purcell . ......
664 Ocean Blvd
AI1?nI1C Beach,Florida 3223�
A d
I have carefully reviewed the HUD-1 SaMement Statomqn�and to the
9kt owledge and belief.it Is a true and accurate Statement ofall
Mandc BtpphF!qtIda�22331 11
receipts and disbursements made on my account or by me In this tritrijack;0 Of�My kkid�.
h. I further cerfify that I have received a copy of HUD-1 Settlement
Statement. THIS HUD-1 SETTLEMENT STATEMENT is BEING USED,IN SUBSTITUTION OF THE 1099,
Buyer 6;nilY Bartharn Purcell Seller
Shiley E.Ball Living Trust
Address
-1 Settlement Statement which I hif,;e.-plfe�d is a true and accurate account of this transaction. I have caused or will cause the funds 0
The HUD
be disbursad In accordance with this
I
Settlement Agent OLD REP 12AO77
Dole: May 25,2012
WARNING: it is a crime to knowingly make false statements to the United States on this Or any other similar form.Penalties upon convi c n
include a fine and imprisonment, For details see Title ja U.S.Code Section 1001 and Section I D10, clion a
�Iravious--willons--are obiiwii—
Page 4 of 4 HUD-1
MOY 22.2012 8:22 AM
ATLANTIC BEACH BUILDING DEPT.
DEMOLITION - PROPERTY OWNER
RELEASE FORM
Date:
To Whom It May Concern:
I /We the current property owners ot Lot
Block
��qdi bescription of Property
AKA
(Address of ropeq) haveGontracted with to have
to remove the
(company Name)
koingie r-amny,Duplex.commercial,"atc.)
Prior to the construction of
As a condition of issuing the permit we agree to the following:
I. All utilities are to be located and clearly marked.
2. Once house is removed, lot is to be graded and leveled.
3. All construction debris is to be removed from the property.
4. Affected area is to have grass or seed in place.
*5. Erosion control devices will be put in place and will remain in place until grass
has covered affected area or new structure is completed and landscaping is in
place.
Signa,ure
QuJildlure
THIS SPACE FOR RECORDER'S USE ONLY
OWNER
Signed: ...........- Date:
Before me this ay of in the 6-11�7�ofDuval,state
Of Florida,has-�c,-sonally appeared
Notary Public at Large,State ofFlonda,County ot-Duval.
MY commission expires:
Personafly Known:
Produced Identificai7io-w. ' -or
Settlement Date:May 25,2012
File Number:12A07,7
OLD REP 12AM
L. Settlement Charges
from
Oftimission:$9.600.6'6
Division Of C01Mi.85ion(line 700)as i;l]ow3 field from,
0 a 50()Do- Buyees
7 Sallees
Funds at Fundsst
70. Settlerrient
Wslon Paid at Saftinwt Settlement
800. Items PS Join onneci !!with
a
801 Out OrV lion 6
Iff—YO-1--.dif-.,Eta-V-(Piiing,)
',rate $0.00
an in GFE#2)
apt. $0 00
(sisal Fee ((rc--- -
CAM, in GFIF
LI
Va. Tax Service*
6K A662d aftffat-jan
n4sr to 6j-ji4 Fjd
Zing
-9 L Owl ,is se
1z-Mo r in rest
n.;"'
"OTOOwner's Inj7U-ra-n-ce from GF
fro GF8
frorn GF #1
87r-
I �.vo_
Horriii;"As nsurancg M,
U'r—a ftLM PFE 09
IW4. pr
-f-10j7—Ti&
and 1—y-ii—nee
to Keith Watson Tft Services,Inc.
-jid-3- Ow-nersTillitnauran' (Old Repubic National title $
1104. Lender's Tift Insurance .11 -6 noe Coinpa�yj
Lender's Prarniu, (Old Republic National Title 11 ura' 650.00
pany) '06—0
0
1 ITOC $
MI 50, 6()o
1107. ent's P .00
n of the Total Itle lrsutaj�j�
F rernUM
1TC66-, nds tars a ince Pre,—'
es Title Poll L' - $6 cis
Government Reco Itis _�ftutn ;;$:2;7327�50
1201' a 7�i6 Er'� -= 7.SY—-—
nWT*nt Re a 9
12
1 3. 18.60— Mo a rorn GF-E i97 --447.0pop
tan$ r axAgns Ral... ............
1204, 1 oun I,
I State taW$lpgMpg
Dead 650.
00 M.-
r RX ------ 4
i is
1301 Requited ...........
302'
Mcas that you c"nqop jro�
Woo
kj romGFE#S),
.00
—1400. T*Ul Settlement Ctm'g"(Enter on UnG 103,Section J and line 602.Section K)
$297.00 $14,926.00
Pre
1;age
RUD-1
MBY 22,2012 8:22 AM
Frow6enesis Hulldlmg Corp 904 241 0326 08/14/2012 14:19 #429 P.002/002
NOTICE OF COMMENCEMENT
Permit No.
Tax Folio No.—
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property,and in accordance with Section
713.13 of the Florida Statutes,the following information is provided in this NOTICE OF COMMENCEMENT.
I.Description of property(legal description
a)Street(fob)Address: �_glp 61cl
2-Gencral description Of improvements: L
3-Owner Information
a)Name and address-
--oCAW'\
b)Name and address Of fee SiMp o titleholder(if other than owner)
e)Interest in property
4.Contractor Information
a)Name and address: 1665co 011('01 '(�-j To ai
-7�
b)Telephone No.: Fax No.(Opt.)
5.Surety Information — x1-0 3
a)Name and address;
b)Amount of Bond:
6.Lender c)Telephone No.: ax No.(Opt.)
a)Name and address:
Phone No.
7.ldcnfl�o—fpersonwithin the gia—te�f- onda designated by owner upon whom noticc�'01 Wother d-ocuments�mxy be�wyed�.
a)Name and address:
b)Telephone No.:
,ownerdeqjgnstes the following
8.1n addition A himself Fax No.(Opt.)
713.13(l)(b),Florida Statutes: )erson to receive a copy of the Lienor's Notice as pr
a)Name and address,
b)Telephone No.: Fax No.-(Opt.)-
9.Expirstlon date OfNatice ofCo mencement(the expiration date Is Ont Year from the date of recording unless a differeht date
is specined):
WARNING TO OWNER: ANY PAVMENTS MADE,OV THE OWNER AVI`E R THIE EXPIRATION OF THE NOTICE OF
COMMENCEMENT ARE CONSIOrREV IMpROVER PAYMItNTS UNIDER CHAPTER 713,PART 4 SECTION 713.13,
FLA)RIDA STATUTES,AND CAN RESUI.,I,IN VOUR pAVINC,*1 ICL(FOR MpROVV
A NOTICE OF C0MMyN(,,r %v 'ME %) no 1K]ITY
,MV 'NIS 1 OtR P
,NT MI)ST"IF
PC D AND POsTgo ow Tjj r,jO"snp,REFORVIVE FIRST
INSPEC110N. IF YOV INTr.ND'I'OOJfl'AIN.IrINANCING,tloNsvi;jr,yotik IiENDER ORAN ATTORNZY HKI RE
CAMMIP-NCTNO WORR Oil I4V,(*,'0jkj)jt*j(jr i(OtIlt NC)TtCle,Op C0MMr'NCl?'M V'NT. 00
5rATX Oy FL01410A
ot'o
I S Wig '%wr
..W. rbr
int Name
The foregoing instrument was acknowledged burbre me this day of
20 /,),by
(type Of Authority,&R.ofter,trustm
attorney In filet)for
(11affle ofpA11y oil behoiror whon,Instrument was txecuted).
PemOffHtIY-k60WP OR Produced Idaltiflcation Notary SigriftfilrO
Typo of Identifloation Produced
Name(print)
OR
Vcrificalion pui�unnt to Section 92.52.1.Florida Sfalulrq.Under ponalties atper ury,I cle-clart.Ihisl I hfivc,read the Forcgoinp.i1n(I thfit
the facts staled in it are true to(he bcs(ofmy knowlcdpc-.and bolier. J
WILLIAM L.POPE
Doo#2012123078,OR BK 15968 Page 2441, Notary Public,State of Florlde
Number Pages:1 I'Lnansij�ni N I MyNtemm
Recorded 0&1412012 at 02:04 PM, Expires Out 19,211`16
JIM FULLER CLERK CIRCUIT COURT DUVAL commission No.EE 121045
COUNTY
RECORDING$10-00
Frowl3enesis Build1mg Corp 804 241 0326 06/14/2012 14:19 #429 P.0011002
TODD A.BOSCO Insured and Ucwsed
cBH CBC12W212
BOSCO CUSTOM HOMES, INC.
DESIGN & REMODEL
DATE:
TO: CSA
o U 'o2 V7 v r
RE: 9a 60/2 &'�g= ( VLVU/bjS/,j- -7t� ) �J6C,
der
ATT: hQ1) ok 1111�
Number of pages including this confirmation:
COMMENTS:
FROK .
BOSCO CUSTOM HOMES, INC.
2158 Mayport Road * Atlantic Beach, Florida 32233
Phone (904) 241-0320 - Fax 1-904-241-0326 9 www.boscocustomhomes.com